Beneficiary User Registration

Bank Details

Dealing Branch Details

Nodal Agency Name
Address
Phone
Fax
Email
IFSC Code
MICR Code

Branch Name
Address
Contact Officer
Mobile
Fax
Email

Unit Details

Registered Office Details

Unit Name*

Please Enter the Unit Name

Unit Pan No.*

Please Enter the Unit Pan No Please Enter Valid Pan No.

MSME*

Yes

No

Please select Unit MSME or not

CIN No.

DIN No.

Unit Type*

Please Select Unit Type

If Others

Enter Unit Type

Gender

Male

Female

Please select Gender

Whether belongs to SC/ST

SC

ST

General

Please select one

Whether belongs to minority community

YES

NO

Please select minority community

Existing Unit*

Yes

No

Please select Unit Existing or not

Incorporation Date*

Please Enter the Incorporation Date

Address
Registered office State
Registered office District
Registered office Taluka Name
Registered office Pin code
Mobile*	Please enter the mobile number Please enter valid mobile number
Phone
Fax
Email*	(Verification mail will be sent on this Email Id to activate the account) Please Enter the Email Please Enter Valid Email Address
Security Question*	Please select the security question
Answer*
Verification Code*	Please enter verification code

* mark fields are mandatory.

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